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Irritant contact dermatitis is a common peristomal skin complication. Due to the continuous irritation from intestinal fluids and faeces, the healing of this dermatitis is slow and the condition severely impairs patients' quality of life. The study aimed to evaluate the efficacy of a modified insertable ostomy appliance in promoting healing and improving patient outcomes. A randomised controlled trial was conducted from January 2022 to December 2024 in a tertiary hospital. The enrolled patients, all diagnosed with irritant contact dermatitis, were randomly assigned to two groups. The control group wore the conventional two-piece ostomy appliance, while the experimental group wore the modified insertable ostomy appliance. Outcomes were assessed on Days 3, 7, 14 and 28. The primary outcome was the healing rate (Discoloration, Erosion and Tissue overgrowth [DET] score ≤ 2) at Day 28. Secondary outcomes included the DET score, Visual Analogue Scale (VAS) pain score, Stoma Quality of Life questionnaire (Stoma-QOL) score and the incidence of appliance leakage. A total of 89 eligible participants completed the trial. The experimental group showed a significantly higher 28-day healing rate (73.3% vs. 29.5%, p < 0.001), lower DET scores (Day 28: 2.0 vs. 4.5, p < 0.001), reduced VAS scores (Day 28: 1.5 vs. 2.0, p < 0.001), higher Stoma-QOL scores (Day 28: 55.67 vs. 51.64, p < 0.001) and lower leakage rate (13.3% vs. 93.2%, p < 0.001). The modified ostomy appliance significantly improves healing, reduces pain and enhances quality of life, representing a novel solution for clinical practice.
This study identifies instruments for assessing the burden on family caregivers of cancer patients and evaluates their psychometric properties using COSMIN criteria.
A systematic review based on COSMIN methodology.
The review adhered to PRISMA guidelines. Relevant studies were identified through searches in PubMed, Web of Science, Cochrane Library, Embase, China National Knowledge Infrastructure, Wanfang Database, and China Science and Technology Journal Database, covering literature from inception to September 2024. Included studies focused on developing or validating measurement tools and assessing psychometric properties such as reliability, internal consistency and construct validity. Two independent researchers screened the literature, extracted data and evaluated psychometric properties using COSMIN criteria while assessing evidence quality via the GRADE method.
A total of 32 studies were included, encompassing 17 tools for assessing caregiver burden. None reported measurement error, cross-cultural validity or responsiveness. The Caregiver's Burden Scale in End-of-Life Care (CBS-EOLC) demonstrated strong reliability, validity and internal consistency, receiving a strong recommendation for clinical practice. In contrast, the Zarit Burden Interview (ZBI), Family Caregiver Burden Interview Scale (FBIS) and Bakas Caregiving Outcomes Scale (BCOS) are not recommended due to insufficient supporting evidence. Other tools showed weak evidence, leading to weak recommendations.
The CBS-EOLC exhibits comprehensive psychometric properties suitable for clinical applications. The ZBI, FBIS and BCOS lack adequate supporting evidence and are not recommended. Future research should focus on measurement error, cross-cultural validity and responsiveness to enhance these tools' applicability and reliability.
This review provides evidence for healthcare providers to select instruments for assessing caregiver burden in cancer patients.
This systematic review highlights the need for comprehensive assessments of caregiver burden based on COSMIN guidelines.
This study is a systematic review with no patient or public participation.
To comprehensively examine the prevailing condition of care dependence among middle-aged individuals who have experienced hemiplegia subsequent to a stroke and were currently undergoing post-acute rehabilitation. Additionally, the study sought to analyse the determinants that impacted this phenomenon.
A single-centre, cross-sectional study design.
During the period from January 2020 to October 2022, a cohort of 196 hemiplegic stroke patients, aged between 40 and 65, and within 6 months of their stroke onset, was selected from the cerebrovascular outpatient clinic at a tertiary hospital in Hangzhou. The demographic and disease-related data, care dependence level, mental state, nutrition and depression status were collected. Furthermore, all collected data were analysed by descriptive and correlative statistical methods.
The care dependence level was 51.04 ± 9.42, with an incidence of care dependence of 78.1%. Multivariate regression analysis showed that age, history of falls, physical dysfunction, chronic comorbidities, depression, nutritional status and cognitive dysfunction were influencing factors for care dependence in the participants after a stroke.
The incidence of care dependence among hemiplegic patients aged from 40 to 65 years old in the early stage after a stroke was high. Nursing staff should focus on these patients with a history of falling, physical dysfunction, comorbidity, depression status, nutritional status and cognitive dysfunction in clinical practice.
The incidence of care dependence in middle-aged hemiplegic patients following a stroke is significantly increased. Some risk factors should be assessed, monitored, and controlled by nursing staff as early as possible in order to reduce the dependence levels in post-acute rehabilitation period and improve the quality of life of hemiplegia patients.
Our study complies with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Checklist: cross-sectional studies (see Table S1).
No patient or public contribution.
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